Work

Body mass index and waist-hip ratio – Risk factors for aortic valve disease: The atherosclerosis risk in communities (ARIC) study

Year: 2026

Type: article

Abstract: Background: Elevated body mass index (BMI) has been associated with increased risk of aortic valve stenosis (AS) in observational and Mendelian randomization studies; however, its association, and that of waist-hip ratio (WHR), with aortic valve insufficiency (AI) remains unclear. We investigated the association of BMI and WHR with incident aortic valve disease (AVD) in the ARIC Study. Methods: We analyzed ARIC participants with echocardiograms at Visits 5 (2011-13) and 7 (2018-19). BMI and WHR were assessed at Visit 5. Incident AVD between Visits 5 and 7 was categorized as aortic valve sclerosis, AI without stenosis, and AS. Multinomial regression models were employed. Results: Among 1931 participants (mean age of 73.5 ± 4.2 years, 59.7% female, and 23.2% Black), 572 (29.6%) developed AVD (345 aortic valve sclerosis, 159 AI, and 68 AS). Higher BMI was associated with a greater incidence of aortic valve sclerosis (OR: 1.29 per 1-SD (5.08 kg/m2), 95% CI: 1.13-1.48) and AS (OR: 1.28, 95% CI: 1.00-1.63), but not AI (OR: 0.93, 95% CI: 0.75-1.14). Higher WHR was associated with an increased risk of incident aortic valve sclerosis (OR: 1.17 per 1-SD (0.079), 95% CI: 1.00-1.35), AS (OR: 1.44, 95% CI: 1.11-1.85), and also AI (OR: 1.24, 95% CI: 1.01-1.53). Conclusions: Higher BMI is a risk factor for incident aortic valve sclerosis and AS, but not AI. Greater WHR is a risk factor not only for incident aortic valve sclerosis and AS, but also for incident AI. Avoiding abdominal obesity may prevent non-rheumatic AVD in older adults.

Source: American Journal of Preventive Cardiology

DOI: 10.1016/j.ajpc.2026.101600